This invention relates to the treatment of injuries to the foot, and more particularly, to a low cost orthosis for treating patients with toe injuries.
Toe injuries are extremely common, both sprains and fractures. Treatment generally consists of reducing any fracture and splinting the toe by taping it to an adjacent uninjured toe with gauze between the toes. The patient is given additional padding and tape so that he can revise the splinting which will be required for about one week. Additional treatment includes rest, ice, elevation and anti-inflammatory medication. Comfort may be provided by use of a cane, crutches, or other method which minimizes weight-bearing flexion and extension of the toes. Wearing shoes generally causes increased pain due to confinement and rubbing of the toe by the shoe. Some patients find that wearing a soft slipper or a sneaker with the toe section cut off gives comfort. Symptoms generally improve within one week.
The treatment for toes following surgical correction of mallet toe, hammer toe, or claw toe, or following the removal of hard or soft corns also requires that weight-bearing flexion and extension of the affected toe be prevented and that the toe be protected from further injury due to contact with fixed objects. The treatment of inflammations and infections of the toes is similar. Patient comfort is enhanced by preventing weight-bearing movement of the toes and preventing their contact with other objects.
Common to all treatments is that movement of the injured toe be prevented. This severely limits patient mobility since walking involves a heel strike, pivoting on the ball of the foot, and launching, with the ball of the foot and the toes supporting the patient's weight during the launch. Weight-bearing flexion and extension of the toes occurs with each step. Use of crutches can limit this flexion and extension, however, patient mobility is limited and no protection is given to the injured toe to prevent additional injury due to accidental contact with fixed objects. Wearing a soft slipper or a sneaker with the toe section cut off, while providing some patient comfort, will often not totally eliminate weight-bearing flexion and extension of the toes and will expose the injured toes to additional injury since the toes are unprotected.
Orthoses exist for the treatment of other injuries to the forefoot. Typical of these is the Orthowedge Healing Shoe (Markell Shoe Company, Yonkers, N.Y.) which, according to their literature, “elevates and unweights the forefoot after surgery or injury”. The outsole of the shoe is much thicker than that of a standard shoe so as to form a platform, and is angled somewhat so that the forefoot is elevated above the heel area. The weight-bearing portion of the outsole extends from the heel of the shoe a distance which places its distal end under the distal half of the arch. The outsole then tapers abruptly to a reduced thickness which extends distally a distance which places the distal end of the outsole slightly beyond the distal end of the wearer's toes. The toe region of the shoe is open so as to minimize contact with the injured region of the foot. The upper portion of the shoe is made from soft, compliant materials and has a dorsal split along its top surface. This allows the foot to be inserted into the shoe with a motion that is substantially orthogonal to the sole of the shoe thereby preventing inadvertent contact between the injured forefoot and the shoe. This is in contrast to a standard shoe which requires insertion of the forefoot with a motion substantially parallel to the insole of the shoe. The Markell shoe elevates the forefoot so as to prevent the distal end of the orthosis from contacting the floor during walking. Pivoting and launch occur from the distal end of the weight-bearing portion of the outsole, which is beneath the metatarsal arch of the user's foot. This unnatural pivot and launch, and the thickness of the platform in the heel area make walking ungainly. The unnatural pivoting effect is amplified by the distal limit of the weight-bearing region which is a defined edge rather than a radius. Because the insole is essentially a flat surface, during pivot and launch some weight-bearing flexion of the toes still occurs. Additionally, an orthosis of this type is of rather complex construction, containing a variety of materials and designed to have a life significantly longer than that generally required for treating a toe injury.
No effective orthosis is available for the treatment of injuries, infections, or inflammation of the toes.
It is accordingly an object of this invention to provide an orthosis for treatment of toe injuries.
It is also an object of this invention to provide an orthosis for toe injuries which mimics true physiology during walking so as to minimize its effect on the patient's gait.
It is also an object of this invention to provide an orthosis for toe injuries which allows a launch from the ball of the foot without load-bearing flexion or extension of the toes.
It is also an object of this invention to provide an orthosis for toe injuries which protects the toes from further injury.
It is also an object of this invention to provide an orthosis for toe injuries which is lightweight and effective.
It is further an object of this invention to provide an orthosis for toe injuries which is of simple construction.
It is finally an object of this invention to provide an orthosis for treatment of toe injuries which is low cost.
It is further an object of this invention to provide an orthosis for toe injuries which can be used on either the left or the right foot.